- The Texas Medical Board has adopted a broad set of telehealth and telemedicine rules and regulations, bringing the once-resistant board in line with legislation passed this year to improve digital health adoption in the Lone Star State.
The new rules, unveiled in September and put into effect on Nov. 26 following a period of public comment, could mark the end of a years-long battle to bring telehealth and telemedicine to Texas. They conform with SB 1107, signed into law by Gov. Greg Abbott in May, which – among many other things – enables Texas practitioners to establish a doctor-patient relationship with new patients by telehealth.
They also define how physicians can use telemedicine to issue prescriptions. Per state law passed earlier this year, the board has to set those rules jointly with the Texas Board of Nursing, Texas Physician Assistant Board and Texas Board of Pharmacy.
“The proposed rules largely defer to the statute's language and eliminate quite a few of the prior obstacles regarding practicing via telemedicine,” Nathaniel Lacktman, a partner in the Foley & Lardner law firm and chairman of the firm’s telemedicine team, said in a blog this past September.
The new rules were embraced by telehealth provider Teladoc, whose bid to provide primarily-phone-based telehealth services ran afoul of the board’s efforts to mandate an in-person meeting between doctor and patient before any telehealth service was rendered. That dispute prompted Teladoc to file an antitrust suit against the board on charges it was interfering with the company’s right to do business in the state.
Teladoc officials announced this past week that they had dropped the suit.
“As we have said throughout this process, Teladoc remains steadfast in our commitment to continue to champion and transform access to high quality healthcare,” the company said in a Dec. 1 post on its website. “Today we could not be happier with the outcome, and the alignment of the legislators and medical regulators on behalf of the people of Texas.”
The board’s new rules set broad definitions for telehealth and telemedicine and allow mental health providers in the state to offer telehealth services. They also establish a framework for nurses, physicians’ assistants and pharmacists to handle prescriptions through telemedicine, while limiting treatment for chronic pain (an apparent nod to the opioid abuse crisis).
While the board’s new rules mark what should be final chapter in the effort to expand telemedicine and telehealth in Texas, they aren’t without controversy. During the public comment period and an Oct. 20 public hearing, several groups – including the Texas Medical Association, Texas Nurses Association, the Coalition for Nurses in Advanced Practice (CNAP) and the ERISA Industry Committee (ERIC) – argued that the new rules were too vague and could deter doctors from using telehealth.
Among the changes that were made by the board following the public comment period was a clarification of who could offer telemental health services. The board struck the phrase “practice of medicine” from the list of qualifications.
“The amendment … recognizes that mental health services can be provided by a number of different providers who are not physicians,” the board wrote. “Many of these providers have their own licensing requirements and defined scope of practices. The rule insures these mental health providers may continue services as long as in compliance with all applicable laws and rules.”
Among those fully supporting the new rules are the Texas e-Health Alliance, Texas Academy of Physician Assistants and the Texas Hospital Association.